"العراق والخليج الفارسي" [و‎‎٢‎٧‎٦] (٨٦٢/٥٥٤)

PUBLIC HEALTH AND DISEASE 427
which is not a venereal disease. It is pre-eminently a disease of child
hood. The parasite is passed from person to person by immediate
non-sexual contact, the transfer being favoured by general uncleanli
ness and lack of segregation. The use of a common drinking-bowl,
kissing and fondling of infants, and possibly flies, lice, and fleas, may
also be factors in the spread of the disease, which is highly contagious.
Adults who have escaped infection in childhood may thus contract it.
Hudson (i 937 )> i n writing of bejel as it occurs among the semi
nomads of the Euphrates valley in Syria close to the Iraq border,
states that ‘seventy-five per cent, of the adult villagers say that they
have had bejel, and from a consideration of the histories, the positive
serological reactions, and the syphilitic lesions and scars, it is permis
sible to conclude that over 90 per cent, of the adults are syphilitic’.
The tribesmen speak of the disease without shame, and distinguish it
from venereally acquired syphilis which is largely confined to the
towns. Clinically bejel is not so serious a disease as is syphilis of
venereal origin and it does not appear to decrease fertility or increase
the rate of miscarriage, as does syphilis. The proportion of bejel is
highest in the provinces of Mosul, Dulaim, and Amara. These three
have a low incidence of gonorrhoea. The fellahin and nomadic tribes
men have a strict sexual code which reduces promiscuity to a negligible
quantity in the country districts, but their very low standard of personal
hygiene, in other respects, facilitates the transmission of contagious
diseases generally.
Venereally acquired syphilis is abundant in the towns. Several
writers have stated that this disease is milder in form than in the
West. The Health Department has devoted much attention to com
bating the disease. Brothels and prostitutes are inspected and con
trolled, and treatment centres have been multiplied.
Gonorrhoea
The total number of cases of gonorrhoea treated in medical institu
tions in Iraq in 1939 was 20,054, nearly two-thirds being in Baghdad
province. This is probably an indication of facilities for treatment
and more efficient control in Baghdad rather than that the disease is
more prevalent there than elsewhere. Gonorrhoea is certainly very
prevalent in the towns of Iraq.
Tuberculosis
Tuberculosis is an important cause of sickness and death in Iraq,
but published information is insufficient to determine its prevalence.